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Academic literature on the topic 'Periosteal Artery Flap'
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Journal articles on the topic "Periosteal Artery Flap"
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Tanner, Cary, Toby Johnson, Alex Majors, et al. "The Vascularity and Osteogenesis of a Vascularized Flap for the Treatment of Scaphoid Nonunion: The Pedicle Volar Distal Radial Periosteal Flap." HAND 14, no. 4 (2018): 500–507. http://dx.doi.org/10.1177/1558944717751191.
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Background: Vascularized periosteal flaps from the distal radius have been previously proposed. The purpose of this study was to investigate the vascularity and osteogenic potential of a vascularized volar distal radial periosteal flap for the treatment of scaphoid nonunion. Methods: In 5 fresh frozen cadavers, a rectangular periosteal flap was elevated from the distal radius with the pedicle just proximal to the watershed line. Latex dye was injected into the radial artery proximally and the vascularity of the flap characterized by microscopic evaluation. Patients with scaphoid nonunion were then treated with open reduction, internal fixation, and distal radius cancellous bone graft. Two groups of patients with midwaist nonunion scaphoid were then evaluated. The first group received the vascularized periosteal flap and the second group received a nonvascularized periosteal flap. A third group of proximal pole nonunions also received the vascularized flap. Results: Cadaveric dissections revealed that all of the injected flaps demonstrated vascularity to the distal edge of the flap. Vascularized flaps formed visible bone on imaging in 55% of cases. None of the nonvascularized flaps formed visible bone. In group 1, 12/12 midwaist nonunions united. In group 2, union was achieved in 6/6 of patients who completed the follow-up. In group 3, 6/7 proximal pole fractures united. Conclusions: Previously proposed vascularized periosteal flaps from the distal radius appear to possess notable osteogenic potential that may be of interest to surgeons treating scaphoid nonunion.
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Scampa, Matteo, Vladimir Mégevand, Jérôme Martineau, Dirk J. Schaefer, Daniel F. Kalbermatten, and Carlo M. Oranges. "Medial Femoral Condyle Free Flap: A Systematic Review and Proportional Meta-analysis of Applications and Surgical Outcomes." Plastic and Reconstructive Surgery - Global Open 12, no. 4 (2024): e5708. http://dx.doi.org/10.1097/gox.0000000000005708.
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Background: Recalcitrant bone nonunion and osseous defect treatment is challenging and often requires vascularized bone transfer. The medial femoral condyle flap has become an increasingly popular option for reconstruction. The study aims at reviewing its different applications and synthesizing its surgical outcomes. Method: A systematic review including all studies assessing surgical outcomes of free medial femoral condyle flap for bone reconstruction in adults was conducted on January 31, 2023. Flap failure and postoperative complications were synthesized with a proportional meta-analysis. Results: Forty articles describing bony reconstruction in the head and neck, upper limb, and lower limb areas were selected. Indications ranged from bony nonunion and bone defects to avascular bone necrosis. Multiple flaps were raised as either pure periosteal, cortico-periosteal, cortico-cancellous-periosteal, or cortico-chondro-periosteal. A minority of composite flaps were reported. Overall failure rate was 1% [95% confidence interval (CI), 0.00–0.08] in head & neck applications, 4% in the lower limb (95% CI, 0.00–0.16), 2% in the upper limb (95% CI, 0.00–0.06), and 1% in articles analyzing various locations simultaneously (95% CI, 0.00–0.04). Overall donor site complication rate was 4% (95% CI, 0.01–0.06). Major reported complications were: femoral fractures (n = 3), superficial femoral artery injury (n = 1), medial collateral ligament injury (n = 1), and septic shock due to pace-maker colonization (n = 1). Conclusion: The medial femoral condyle flap is a versatile option for bone reconstruction with high success rates and low donor site morbidity.
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Bartholomew, Ryan, Joseph Zenga, Derrick Lin, Daniel Deschler, and Jeremy Richmon. "Tip-on-Tip Scapular (TOTS) Flap for Reconstruction of Combined Palatectomy and Rhinectomy Defects." Facial Plastic Surgery 34, no. 04 (2018): 389–93. http://dx.doi.org/10.1055/s-0038-1666784.
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AbstractCombination anterior palatectomy and rhinectomy defects result in complete loss of midface and nasal support and present a significant reconstructive challenge. A novel use of the scapular tip free flap—the tip-on-tip scapula flap—was developed to provide both palatal repair and restoration of intrinsic nasal support. The scapular tip bone is split into a large proximal segment for the anterior palate and a smaller distal bone segment for nasal framework reconstruction. Two patients undergoing reconstruction of both total palatectomy and partial rhinectomy defects at a single academic tertiary care center were reviewed. In both cases, the larger proximal segment of the scapular tip flap, used for the palatal defect, was based on the angular artery. The distal bone segment, used for nasal framework repair, was vascularized in one of two ways. In the osteomyogenous serratus-scapular tip variant, the serratus arterial branch provided periosteal blood supply to the bone through a cuff of attached serratus muscle. In the split-scapular tip variant, the periosteum of the scapular tip was kept in continuity with the distal bone segment and fed through the periosteal vascular arcade from the angular branch. In both patients, the distal bone segment demonstrated robust intraoperative vascularity and both flaps healed without complication. Both patients were able to resume oral diets and had good nasal breathing.
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Sanjay, Kumar, and Kumar Prakash. "Reverse Sural Flap for Regeneration of the Soft Tissues in the Ankle and Heel." International Journal of Pharmaceutical and Clinical Research 15, no. 7 (2023): 465–69. https://doi.org/10.5281/zenodo.11642268.
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<strong>Introduction:</strong> It has never been easy to restore large soft tissue lesions in the ankle and foot. There has been varying success using reverse sural flaps and free flaps for this issue. Without microvascular repair, the reverse peroneal artery flap is an alternative that can be used reliably. Anterior and posterior tibial arteries form deep and reliable connections with the peroneal artery around the talus and ankle joint. When the short saphenous vein and the reverse sural artery were included into the flap, arterial input and venous drainage improved. <strong>Materials and Method:</strong> Over the course of two years, ten patients with significant heel deformities underwent repair with a reverse peroneal artery flap (pedicled). Final inset given after initial surgery has healed after 18–21 days. These patients were 45 years old on average. <strong>Results:</strong> All ten flaps displayed full survival, with no signs of even minor necrosis. Two patients reported minor donor site issues that were treated conservatively and resolved. <strong>Conclusions</strong><strong>: </strong>For the purpose of covering significant soft tissue deformities of the heel and sole, RPAF is a very dependable flap. Without vascular microsurgery and without endangering the major vessels in the foot region, large abnormalities can be repaired. If there is prior knowledge of flapping perforators and a free fibula, RPAF is simple to do reliably.
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Singh, Vivian, and Marcus Atlas. "Obliteration of the Persistently Discharging Mastoid Cavity using the Middle Temporal Artery Flap." Otolaryngology–Head and Neck Surgery 137, no. 3 (2007): 433–38. http://dx.doi.org/10.1016/j.otohns.2007.02.034.
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OBJECTIVE: To evaluate the surgical outcome of patients undergoing obliteration of a persistently discharging mastoid cavity with specific soft tissue vascular flaps for chronic otitis media or cholesteatoma. STUDY DESIGN: A five-year retrospective consecutive case review in a tertiary care referral center. Following mastoidectomy obliteration with a superiorly based middle temporal artery, axial periosteal flap and inferiorly based random pedicled musculoperi-osteal flap was performed. The primary outcome was control of suppuration and the creation of a dry, low-maintenance cavity as assessed by a semi-quantitative scale. RESULTS: A total of 51 consecutive patients undergoing revision mastoidectomy with obliteration were identified with a minimum follow-up of 12 months; 43 (84%) had a small dry healthy mastoid cavity; three ears (6%) had occasional otorrhea that was relatively easily managed by topical therapy. CONCLUSION: Obliteration using the middle temporal artery and inferior random flaps is an effective method to manage patients with pre-existing cavities and also those not previously operated upon.
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Manojlovic, Radovan, Milan Milisavljevic, Dejan Tabakovic, Mila Cetkovic, and Marko Bumbasirevic. "Angiosome of the fibular artery as anatomic basis for free composite fibular flap." Srpski arhiv za celokupno lekarstvo 135, no. 3-4 (2007): 174–78. http://dx.doi.org/10.2298/sarh0704174m.
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Introduction. The free osteoseptocutaneus fibular flap is, anatomically, an angiosome of the fibular artery. Knowledge of detailed topography anatomy of the fibular artery and its branches is necessary for successful creation and elevation of the flap. Objective. The aim of the study was to determine topography of the tissue of the leg supplied only by the fibular artery, to describe topography relations of the branches of the fibular artery, their number, anastomoses, vascular plexus and the way of vascularization of the skin, muscle and bone tissue. Method. The popliteal artery was cannulated in 15 cadaveric legs, flushed with ink and then with 10% ink-gelatin. Fixation of tissue was performed with formalin and then micropreparation of the side branches of the fibular artery was performed. Also, two corrosive models were made. Localization of foramen nutrition was determined by measuring 50 fibulas. Results. The skin supplied by the fibular artery forms distal two thirds of the lateral-posterior aspect of the leg. Vascularization of the skin arises from the side branches of the fibular artery forming a rich fascia plexus at the deep fascia level. From 3 up to 7 side branches of the fibular artery are incorporated in the fascia arterial plexus and can be separated as septocutaneus and myocutaneus, according to topography relations. The nutritive artery enters the fibula cortex at a spot that, measured from the top of the fibula, lies in the area between 32% and 65% of the whole length of the fibula. Periosteal circulation of the fibula originates from the short side branches of the fibular artery that anastomoses at the periosteum level. Conclusion. The axial line of flap has to be marked 2 cm posterior to the line from caput fibulae to malleolus lateralis. Numerous anastomoses between the side branches of the fibular artery in the fascia plexus enable good circulation of the skin even when some of the branches are not included in the flap. The middle third of fibula has to be used as bone graft because of localization of the foramen nutrition. .
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FARRIOR, JAY B. "Postauricular Myocutaneous Flap in Otologic Surgery." Otolaryngology–Head and Neck Surgery 118, no. 6 (1998): 743–46. http://dx.doi.org/10.1016/s0194-5998(98)70262-1.
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Management of a large mastoid defect resulting from skull base operations or extensive surgical procedures because of chronic ear disease continues to challenge the otologic surgeon. Various local muscle or periosteal rotation flaps have been used to help reduce the size of the postoperative mastoid cavity. With these techniques there are problems with flap retraction and epithelization that may result in delayed healing or chronic drainage. Closure of the ear canal and tissue obliteration of the mastoid results in a maximal conductive hearing loss. A postauricular myocutaneous flap based on the occipital artery and sternocleidomastoid muscle has been used effectively to reconstruct mastoid defects after both surgical procedures for chronic ear disease and skull base operations. The skin muscle flap reduces the mastoid cavity and promotes rapid healing of the surgical defect. Although postauricular myocutaneous flaps have been found to be reliable, their viability may be compromised by arterial embolization used in larger glomus tumors. Indications for and creation of a postauricular myocutaneous flap, with results in 18 cases, are presented. (Otolaryngol Head Neck Surg 1998;118:743-6.)
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Knitschke, Michael, Anna Katrin Baumgart, Christina Bäcker, et al. "Computed Tomography Angiography (CTA) before Reconstructive Jaw Surgery Using Fibula Free Flap: Retrospective Analysis of Vascular Architecture." Diagnostics 11, no. 10 (2021): 1865. http://dx.doi.org/10.3390/diagnostics11101865.
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Computed tomography angiography (CTA) is widely used in preoperative evaluation of the lower limbs’ vascular system for virtual surgical planning (VSP) of fibula free flap (FFF) for jaw reconstruction. The present retrospective clinical study analysed n = 72 computed tomography angiographies (CTA) of lower limbs for virtual surgical planning (VSP) for jaw reconstruction. The purpose of the investigation was to evaluate the morphology of the fibular bone and its vascular supply in CTA imaging, and further, the amount and distribution of periosteal branches (PB) and septo-cutaneous perforators (SCPs) of the fibular artery. A total of 144 lower limbs was assessed (mean age: 58.5 ± 15.3 years; 28 females, 38.9%; 44 males, 61.1%). The vascular system was categorized as regular (type I-A to II-C) in 140 cases (97.2%) regarding the classification by Kim. Absent anterior tibial artery (type III-A, n = 2) and posterior tibial artery (type III-B, n = 2) were detected in the left leg. Stenoses were observed mostly in the fibular artery (n = 11), once in the anterior tibial artery, and twice in the posterior tibial artery. In total, n = 361 periosteal branches (PBs) and n = 231 septo-cutaneous perforators (SCPs) were recorded. While a distribution pattern for PBs was separated into two clusters, a more tripartite distribution pattern for SCPs was found. We conclude that conventional CTA for VSP of free fibula flap (FFF) is capable of imaging and distinguishing SCPs and PBs.
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Jacob, V., N. J. Mokal, and S. N. Deshpande. "Bi-lamellar lower eyelid reconstruction with superficial temporal artery island flap and hard palate muco-periosteal free graft." Indian Journal of Plastic Surgery 38, no. 02 (2005): 105–9. http://dx.doi.org/10.1055/s-0039-1699115.
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ABSTRACTThree cases of single stage, bi-lamellar reconstruction of full-thickness, horizontal, lateral three-quarter lower eyelid defects using pedicled island flaps of adjacent vascular territories and hard palate muco-periosteal graft are being presented. All cases were done for Basal Cell Carcinoma of the region. While the island flaps allowed for a simple, single stage reconstruction of the external lamella, the hard palate muco-periosteal graft, by virtue of its inherent resilience and a rich glandular component, took well and provided for a good functional and aesthetic result.The follow-up ranged from 6 to 40 months and the final result has been oncologically, functionally and aesthetically satisfactory.
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Talmage, Garrick D., Jumin Sunde, David D. Walker, Marcus D. Atlas, and Michael B. Gluth. "Anatomic basis of the middle temporal artery periosteal rotational flap in otologic surgery." Laryngoscope 126, no. 6 (2015): 1426–32. http://dx.doi.org/10.1002/lary.25635.
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